The researchers wrote that the development was especially concerning because older people were particularly susceptible to the adverse consequences of antibiotic use, including the potentially fatal Clostridium difficile infection, which is thought to be caused by an imbalance in gut bacteria following antibiotic treatment.

Those surveyed identified the lack of doctors based at nursing homes as a concern, with antibiotics most commonly being prescribed over the phone. Most visiting GPs tended to prescribe antibiotics early rather than waiting and observing patients, and the routine use of locum doctors, particularly after hours and on weekends, was reported as a factor in greater use of antibiotics.

Doctors also reported pressure to prescribe antibiotics from nurses and family members, who often had unrealistic expectations about their effectiveness, while the difficulties in assessing residents with behavioral problems or cognitive deficits also complicated prescribing decisions. Most GPs and nurses believed the frailty of aged care residents justified early use of broader spectrum antibiotics.

One of the researchers, David Kong, a lecturer at the Centre for Medicine Use and Safety at Monash University, said it was a difficult situation for doctors.

''If you've got a patient who is frail and who is looking a little bit sick, they can get sicker very fast,'' he said. ''If it was your dad or mum who was sick, you might want them to be given the broadest spectrum antibiotic, but the broadest spectrum antibiotic might not be the most appropriate.''

The researchers reported mixed views on the role of nurses in managing infections, with some GPs expressing confidence in the judgment of nurses while some nurses themselves reported feeling overwhelmed by their responsibility to manage infections along with the rest of their workload. Others expressed concern about rapid staff turnover, a lack of experienced nurses and variability in the quality of assessments made by nurses.

None of the facilities surveyed had any policy restricting the use of antibiotics and national guidelines were rarely followed, the researchers wrote.

Dr Kong said better professional education and guidance was needed. ''Whenever we are trying to prescribe antibiotics … we need to think about does the patient really need the medication, and is it the right time, is it the right drug and the right dose. It's not about not using it, but using it appropriately,'' he said.

Hodson's daughter: Witness protection not safe

"I feel sorry for anyone coming into witness protection," says the tearful daughter of police informer Terence Hodson after the State Coroner delivered an open finding into his murder and that of his wife Christine in 2004.